Adequate systemic perfusion maintained by a CentriMag during acute heart failure.
Mechanical circulatory support during severe acute heart failure presents options for myocardial recovery or cardiac replacement. Short-term circulatory support with the newest generation of magnetically levitated centrifugal-flow pumps affords several potential advantages. Herein, we present our experience with such a pump-the CentriMag Levitronix LLC; Waltham, Mass) centrifugal-flow ventricular assist device-in 4 critically ill patients who were in cardiogenic shock. From November 2007 through March 2008, 3 patients were supported after cardiac surgery, and 1 after chronic heart failure worsened. Two patients were bridged to heart transplantation, and 2 died during support. Perfusion during support was evaluated in terms of serum lactic acid levels and oxygenation values. In all of the patients, the CentriMag's pump flow was adequate, and continuous mechanical ventilation support was provided. Lactic acid levels substantially improved with CentriMag support and were maintained at near-normal levels throughout. At the same time, arterial pH, PO2, and carbon dioxide levels remained within acceptable ranges. No thromboembolic events or mechanical failures occurred. Our experience indicates that short-term use of the CentriMag ventricular assist device during acute heart failure can restore and adequately support circulation until recovery or until the application of definitive therapy.
Favaloro
Roberto R
RR
Favaloro Foundation, Buenos Aires C1093AAS, Argentina.
Bertolotti
Alejandro
A
Diez
Mirta
M
Favaloro
Liliana
L
Gomez
Carmen
C
Peradejordi
Margarita
M
Trentadue
Julio
J
Hellman
Lorena
L
Arzani
Yanina
Y
Otero
Pilar Varela
PV
D000208:Acute Disease; D002312:Cardiomyopathy, Hypertrophic / Q000601:surgery; D002648:Child; D001026:Coronary Artery Bypass; D023921:Coronary Stenosis / Q000601:surgery; D004867:Equipment Design; D017809:Fatal Outcome; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery; D006333:Heart Failure / Q000628:therapy*; D016027:Heart Transplantation; D006349:Heart Valve Diseases / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000601:surgery; D011183:Postoperative Complications / Q000628:therapy; D012770:Shock, Cardiogenic / Q000628:therapy*